Ounce of Prevention MD: What Does It Mean to Be Healthy?

What Does It Mean to Be Healthy?

A few weeks ago, I had an overweight patient see me for a routine physical. He wasn’t doing very well with his diet or sleep, but had recently started an aggressive exercise routine. I asked him what motivated him to start exercising, and he said, ”I want to be healthy.” I asked what “being healthy” meant to him, and he looked at me quizzically. It was then that I realized that one reason people may have trouble “getting healthy” is because they don’t really know what being “healthy” means.

We all have a general sense of what it means to be healthy – most people would say that someone who is young, thin, athletic and happy is healthy. But what about someone who is vastly overweight and smokes, but feels well and doesn’t have any medical conditions (yet)? What about someone who has Rheumatoid Arthritis and high blood pressure, but runs 5 miles/day and eats well? And is someone “healthy” who’s 85 years old and hasn’t been to the doctor in 10 years, but also feels well? What if they’re physically fit, but depressed?

Photo- Gabin Vallet

As you can see, it’s not so clear – “Healthy” is a nebulous term.

The World Health Organization defines “healthy” as “the state of complete physical, mental and social well-being; not merely the absence of disease or infirmity.” However, this is also vague, because “well-being” is just another term for “healthy.”

I would like to unveil my own definition of “healthy,” fine-tuned over 20 years of practicing medicine. “Healthy” should be defined as the absence of, and at low risk for, chronic suffering.

Chronic Suffering – Physical and Mental

Suffering is not just physical pain. Most people who sprain their ankle don’t visit the doctor, because they trust it’s going to get better on its own. Suffering is also the negative mental and emotional impact of physical or psychological conditions. We all experience intermittent suffering at some point in our lives, such as after a breakup or the loss of a loved one, and we all know it’s not pleasant. However, chronic suffering is a different entity. It occurs when someone is struggling with a chronic illness or persistent mental disorder, and it can be debilitating.

Most people may not think of it this way, but the emotional suffering that comes from a condition is the worst part of any disease. If someone has a stroke and loses use of their right arm, but is still happy and content, they are not suffering. Unfortunately, this is not typically the case.

If asked what a doctor does, the majority of individuals would say that our job is to treat disease and help people live longer. But, I disagree – I feel my job is to extend quality of life as much as possible, not just quantity. When I have an end of life discussion with my patients (which I do regularly, even with healthy patients), almost every one of them states that they do not want their life prolonged by artificial means if their quality of life is diminished.

In other words, they want to avoid suffering.

That may sound obvious, but the connection between “being healthy” and “avoiding suffering” is not a connection most people tend to make directly, especially when it comes to which habits and behaviors they might be motivated to change.

Control What You Can Control

Going back to the patient examples above, you can see there are some factors in health that we can change, and some we can’t. Just being 85 years old is, in itself, a high risk for chronic disease, and therefore a higher risk for chronic suffering. There’s not much you can do about age or genetics. But healthy habits, like diet, exercise, and adequate sleep, all of which decrease our chances of disease and suffering, are within our control.

So the next time you’re trying to get motivated to go jogging or have a salad instead of a burger, think about taking the action, not for “health,” but to prevent or alleviate future suffering. After all, the corollary of “not suffering” is feeling well and continuing a good quality life. Who doesn’t want that?

Good luck, and good “health!”

Ken Zweig, M.D.